Background Although global contraceptive coverage has increased significantly, high rates of unintended pregnancy remain the current global status quo. A comparative analysis of the differences and correlations of knowledge, attitude and practice (KAP) of sexual and reproductive health (SRH) of both partners will help guide public health work according to gender characteristics and needs, and reduce the occurrence of unintended pregnancy. Methods A questionnaire survey of people with unintended pregnancies including women and their male partners (n = 1,275 pairs) who sought help from the Shanghai General Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from October 2017 to October 2021. Data were collected on sexual and reproductive health knowledge, attitudes, and practices in both partners who had unintended pregnancies. Chi-square test and Logistic regression were used to analyze the relationship between the occurrence of unintended pregnancy and KAP and its influencing factors. Paired odds ratio and McNemar's test were used to estimate the difference and concordance of KAP between partners. Results This study included 1,275 partners with a mean age of 30.0 years. The partner's overall level of KAP is good. Compared with women, men had better knowledge (χ2 = 3.93, p = 0.047) and more active contraceptive practices (χ2 = 19.44, p < 0.001). In the analysis of partner concordance, male contraceptive intention was found to be better than female [matched pairs odds ratio (ORMP) = 2.56, p < 0.001], and the concordance of positive contraceptive practice between partners increased with male education [adjusted odds ratio (aOR) = 1.556, 95% confidence interval (CI) = 1.185–2.044, p = 0.001]. In partner-paired regression analysis, compared with good contraceptive knowledge in both men and women in the partner, the risk of negative contraceptive practice was 1.7 times (aOR = 1.721, 95% CI = 1.234–2.400, p = 0.001) higher with good contraceptive knowledge in women but negative in men, while women with poor contraceptive knowledge but men with good knowledge are 1.3 times (aOR = 1.349, 95% CI = 1.000–1.819, p = 0.05) more likely to have negative contraceptive practices. In addition, compared with partners with positive contraceptive attitudes, women with positive attitudes but negative men and women with negative attitudes but positive men had 1.7 and 1.4 times the risk of negative contraceptive practices, respectively. Conclusion The study found that unintended pregnancy occurs mainly in young people, and the younger age of first sexual intercourse, the low education background and the lack of discussion of contraception between partners are risk factors for not taking contraceptive measures. Men's better knowledge and contraceptive practices compared with female partners, and poor male contraceptive knowledge and attitudes may lead to a higher risk of negative contraceptive practices, the results suggest that male KAP plays an important role in promoting contraceptive use and reducing unintended pregnancy.

临床教学是医学理论与实践的结合,对医学生专业能力培养具有重要作用.目前,在线教育方式如慕课、SPOC、微课、在线虚拟训练、在线案例教学等在临床带教中逐渐应用,已成为重要的教学方法之一.本文对国内现有的在线教育方式在临床教学中的应用现况和实施途径进行探讨,为在疫情防控常态化形势下在线临床教学的开展提供参考.

Background Neoadjuvant chemotherapy (NACT) has been applied for the treatment of patients with advanced-stage epithelial ovarian cancer (EOC), fallopian tube cancer, and primary peritoneal cancer, as these patients have a low likelihood of achieving optimal debulking and are thus poor surgical candidates. Herein, we explore the effects of NACT and compare the surgical outcomes and recurrence data in patients who receive interval debulking surgery followed NACT(NACT-IDS) or primary debulking surgery(PDS). Methods A retrospective, single-center, observational study was conducted. Patients with advanced-stage EOC, fallopian tube cancer and primary peritoneal cancer who were treated with NACT or primary debulking surgery were enrolled. The effects of NACT as well as the surgical outcomes and recurrence data were compared between the NACT-IDS and PDS groups. Results The albumin level was elevated (42.61±3.46 g/L vs. 37.47±5.42 g/L, P=0.001) and the levels of CA12-5 and HE4 significantly decreased (P=0.002, 0.003) in patients after neoadjuvant courses. The operation time, amount of blood loss during surgery, rate of bowel resection, time to chemotherapy, and platinum-free interval were comparable between the two groups (P＞0.05). Recurrence-free survival was worse in the NACT-IDS group than in the PDS group (HR=2.406, 95% CI[1.024, 5.657]). Conclusion NACT improved the condition of advanced-stage patients, but a poor recurrence free survival rate was observed; thus, NACT should not be applied in non-selected patients.

Objective:To evaluate the safety and effectiveness of The Stork OTC conception aid kit for the treatment of male infertility compared with natural sexual intercourse.Methods:A multi-center, prospective, open, self-controlled, randomly crossed trial was performed in 57 infertility couples who were unable to naturally conceive, and were selected in Shanghai General Hospital, Shanghai Jiao Tong University, Reproductive Medicine Center,Tongji Medical College, Huazhong University of Science and Technology and Anhui Provincial Hospital from July 2017 to September 2018. Patients were required to participate both the conception aid kit and natural sexual intercourse in two consecutive periods of ovulation. A random envelope method was used to determine the application sequences of two methods. Twenty-nine couples were treated with the conception aid kit in the first month of ovulation, and applied the natural sexual intercourse in the second month of ovulation as group A. Twenty-eight couples were applied the natural sexual intercourse in the first month of ovulation, and were treated with the conception aid kit in the second month of ovulation as group B. Test results collected from all couples who used the conception aid kit were categorized as the test group data. Meanwhile, test results out of those couples who completed natural sexual intercourse were collected as control group data. Compared with its self-controlled natural sexual intercourse two months before and after, the effectiveness and safety of the conception aid kit was verified by general vaginal examination, routine leucorrhea examination, motile sperm score from post coital test (PCT), pregnancy rate comparison and other methods.Results:The trial was conducted at three clinical trial centers. A total of 57 infertility couples were enrolled. A total of 54 couples were validated eventually including 26 couples in group A and 28 infertility couples in group B. Effectiveness was evaluated. The PCT results showed that the sperm score of test group was 6.11±3.00, and the score of the sperm score of control group was 1.22±0.79. The motile sperm score of test group was 5 times ( P<0.001) than that in control group. In the follow-up, 7 (13.0%) of the couples successfully achieved pregnancy with the conception aid kit, 6 (85.7%) of them had healthy offspring, 1 (14.3%) had spontaneous abortion. No couples were pregnant after natural sexual intercourse. Safety was evaluated. The general examination of the vagina and the routine tests of the vaginal leukorrhea showed no difference between test group and control group. All 54 effective couples who completed the test can successfully use the conception aid kid to place the seminal vesicles containing semen and remove them with the attached pulling thread on time without obvious discomfort. Conclusion:The Stork OTC conception aid kits can effectively treat infertility, significantly increase the number of forward-moving sperm entering the cervix, and significantly increase the pregnancy rate. It is safe, non-invasive, simple, can be easily operate by patients themselves, and meets the needs of clinical applications.

Objective:To investigate the reproductive health knowledge, contraceptive attitudes and behaviors of male partners of abortion women and their sources of reproductive health knowledge, and to analyze the correlation among them.Methods:A questionnaire survey was conducted to survey 1085 female's male partners who requested abortion in Shanghai General Hospital, and information on male reproductive health knowledge, knowledge sources, contraceptive attitudes and implementation was collected, and the results were analyzed.Results:"Network" (78.52%, P<0.001) was the most important way for males with various sociological characteristics to acquire reproductive health knowledge, followed by "friends, colleagues" (36.76%), "medical staff" (34.26%), "TV video" (33.80%), and "parental elders" (15.83%) which accounted for the lowest proportion. The more ways for abortion female's male partners to acquire reproductive health knowledge, the higher level of reproductive health knowledge such as contraception and abortion ( P=0.001), the higher active contraceptive attitude (91.49%, P<0.001). Conclusion:The main ways for male to obtain reproductive health knowledge include the internet, healthcare workers, media publicity, etc. and the more access, the more abundant the reproductive health knowledge of men, the more likely they are to take effective contraceptive measures and reduce the incidence of unintended pregnancy abortion.

PURPOSE:Reprogramming of cell metabolism is essential for tumor progression and the best-studied metabolic phenomenon of cancer cells is aerobic glycolysis, in which pyruvate kinase isozyme type M2 (PKM2) plays a critical role. Follicle-stimulating hormone (FSH) contributes to epithelial ovarian cancer progression and has been shown to regulate cell metabolism in ovaries. The aim of this study was to investigate the interaction between FSH and PKM2 and their effect on aerobic glycolysis and cell proliferation in ovarian cancer.METHODS:SKOV3 and OVCAR3 ovarian cancer cells were treated with FSH at various doses to investigate its effect on cell proliferation and PKM2 expression. siRNA-PKM2-transfected SKOV3 and OVCAR3 cells were treated with FSH to examine whether the changes induced by FSH could be altered by siRNA-PKM2. Glucose and lactate levels were evaluated to observe the change in glycolysis in these cells.RESULTS:In the current study, FSH upregulated the expression of PKM2 and glycolysis in SKOV3 and OVCAR3 cells. PKM2 knockdown reduced FSH-induced cell growth and glycolysis. Moreover, FSH attenuated apoptosis that was induced by the inhibition of PKM2.CONCLUSIONS:Collectively, the findings of this study indicated that FSH promoted glycolysis in epithelial ovarian cancer cells. Knockdown of PKM2 inhibited aerobic glycolysis and cell proliferation induced by FSH.

The aberrant expression of miR107‑5p is closely related to the development of several types of human cancers. However, the role of miR‑107‑5p in endometrial carcinoma (EC) has not been fully confirmed. In the present study, we aimed to explore the function of miR‑107‑5p in EC carcinogenesis. EC samples and normal endometrial tissues were obtained by laser capture microdissection. It was determined that the expression of miR‑107‑5p in EC was significantly higher than that in normal endometrium, and higher miR‑107‑5p expression was related to advanced FIGO stages, lymph node metastasis and myometrial invasion in EC patients. Blocking miR‑107‑5p significantly inhibited cell proliferation, migration and invasion of EC cells in vitro and in vivo. The results of bioinformatic algorithms and luciferase reporter assays revealed that estrogen receptor α (ERα) was a direct target of miR‑107‑5p. miR‑107‑5p downregulated the expression of ERα mRNA and protein. In conclusion, our results highlighted that miR‑107‑5p is a novel prognostic factor that targets ERα to promote tumor proliferation and invasion of EC.

Ovarian cancer is the leading cause of death among gynecologic cancers and is the fifth leading cause of all cancer-related deaths among women. The development of novel molecular targets is therefore important to many patients. Recently, the SRY-related transcription factor SOX2 has been widely reported to be involved in multiple pathophysiological diseases, including maintenance of stem cell characteristics and carcinogenesis. Up to now, SOX2 has been mainly shown to promote the development of cancer, although its inhibitory roles in cancer have also been reported. However, the role of SOX2 in ovarian cancer is largely unknown. In the present study, we detected the expression of SOX2 in 64 human serous ovarian carcinoma (SOC) tissues and paired corresponding metastatic specimens using immunohistochemistry. The results showed that the expression of SOX2 in primary tumors is much lower than that in the corresponding metastatic lesions. We further found that SOX2 overexpression promotes proliferation, migration and invasion, while inhibiting adhesion abilities of SOC cells. Finally, we found that SOX2 targets Src kinase, a non-receptor tyrosine kinase that regulates cell migration, invasion and adhesion in SOC cells. Together, these results suggested that Src kinase is a key molecule in SOX2-mediated migration and invasion of SOC cells.

Epithelial ovarian cancer, which is one of the most lethal gynecological tumors, is also the biggest difficulty in the diagnosis and treatment of obstetrics and gynecology. In addition to the lack of early clinical symptoms and effective diagnostic methods, the reason includes the lack of accurate and comprehensive understanding of the development of epithelial ovarian cancer. Thus a lot of research aimed at better grasp of its pathogenesis, which is expected in the future progress of its diagnosis and treatment. Currently, three pathogenesis of epithelial ovarian cancer widely accepted are high gonadotropin theory, “dualism” hypothesis and stem cell hypothesis. This study discussed the theory above.

Objective:To investigate the effect of metformin on the reversal of progestin resistance in the transplanted endometrial tumor of the nude mice and explore the potential mo-lecular mechanism. Methods:Forty mice were divided into two groups randomly for establishing human endometrial cancer animal models that xenograft transplanted subcutaneous in nude mice by cell line of ishikawa and progestin resistance inshikawa/GloI. Each group was randomly di-vided into control group,metformin group,medroxyprogesterone acetate group( MPA) ,metform-in+MPA group. During the period of injection with drugs,we measured the tumor size and ob-served the condition of the mice. At the end of the experimentation,the tumors were dislodged completely then we measured the volume of tumors,drawed the growth curve of the tumors,cal-culated the inhibition rate of the tumor and detected the expression of the GloI, Cyclin D1,mTOR, pmTOR with the method of immunohistochemistry. Results:Metformin group, MPA group,metformin+MPA group injected ishikawa cells inhibited the tumor volume by 36. 63%, 55. 92%,75. 38% respectively. The combination effect was more obvious. The difference was significant(P<0. 05). The inhibition rate of the tumor was 41. 77% in Metformin+MPA group injected ishikawa/GloI cells and showed more effective in suppressing the tumor growth than the control group(P<0. 05). The inhibition rate for metformin group and MPA group were 12. 58%and 2. 79% having no difference with control group(P>0. 05). All groups showed a significanct decreased expression of the GloI,Cyclin D1,mTOR and pmTOR except for the MPA group in-jected ishikawa/GloI cells,compared with those in the control group(P<0. 05). Conclusions:Metformin reverses progestin resistance in the transplanted tumor of the nude mice. Down-regu-lation of GloI,Cyclin D1,mTOR,pmTOR protein may be one of the mechanisms through which metformin reverses progestin resistance.

The understanding and application of anti-Mullerian hormone( AMH) were mainly limited to gynecology reproductive endocrinology in the past days. While in recent years, more studies have been focusing on the correlation between AMH and gynecologic oncology. In accordance with the present research, granulosa cell tumor( GCT) of ovary has the highest correlation with AMH,which has been proven to be an effective serum tumor marker in clinical practice for early diagnosis, therapeutic effect evaluation, prognostic evaluation, and recurrence monitoring. The further researches find that AMH can also significantly inhibit epithelial ovarian cancer cells, so it promises to be a new auxiliary therapy for epithelial ovarian cancer. Additionally, the correlation between AMH and cervical cancer and whether it may be a new targeted therapy are worthy of further studying.

Tumor stem cells play an important role in the occurrence and development of cancer.Sox2 is an important transcription factor of stem cells and its abnormal expression may promote the occurrence and progress of a variety of malignant tumors,besides its potential in maintaining self-renewal and multidirectional differentiation potential of stem cells.The specific mechanism is involved in tumor proliferation,differentiation,invasion,metastasis,and drug resistance,etc.At the same time,Sox2 is closely associated with epithelial-mesenchymal transition,which is an important biological process in malignant tumor cell of epithelial origin gaining the ability of migration and invasion.The studies of Sox2 in the field of cancer research helps to find new clinical treatments.